Commencing January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide as a requirement of new laws on hospital price transparency. According to (CMS), hospital price transparency ruling should help Americans know the cost of a hospital item or service before receiving it in two ways:
- 1. As a comprehensive machine-readable file with all items and services. MachineCode
- 2. In a display of shoppable services in a consumer-friendly format.
- 3. To remain in compliance for Self Funded Groups, Wellmark Insurance requirements we have included the following link that provide Machine Readable File.
This information should make it easier for consumers to shop and compare prices across hospitals and estimate the cost of care before going to the hospital. Below are links relating to the new rule and how we developed our site to comply with new rules:
- 1) https://www.govinfo.gov/content/pkg/FR-2019-11-27/pdf/2019-24931.pdf
- 2) https://www.cms.gov/hospital-price-transparency
Disclaimers – As with anything provided in writing we as an organization are disclosing the following:
- 1) This estimate is based on averages charges for this procedure without complications. Your charges may vary based on your situation, the amount of time the procedure takes and the care of your doctor orders for you based on your medical needs. You also may receive bills from other medical specialty services that you may use during your visit with us including physician, anesthesiology charges, radiologist reading fees and pathologist fees. These charges may be separately billed through their respective organization.
- 2) The estimate is not a quote or guarantee of the charges for a service or the amount that you owe. Your insurance and policy coverage will ultimately dictate what your costs will be, which would include deductibles, co-pay, co-insurance, and out of pocket maximums. This information can be obtained directly from your insurance company and recommended that you do in fact contact them to make sure you are aware of what your insurance will and will not cover.
In order to proceed with obtaining a cost of a “shoppable service”, please select your health insurance company’s name from below:
- Midlands Choice
- United Health Care
- United Health Care (Medicare Advantage)
- Cash/Self-Pay (No Insurance), Minimum and Maximum
These insurance companies relate to ones in which we have an existing agreement, if you do not see your insurance in our list it could be that they negotiate what they will pay upon billing of services or through a re-pricing agency.